Artificial pancreas study helps teenager manage his diabetes

An Oxfordshire teenager who is using a mobile phone app connected to a pump to deliver insulin as part of a study into type 1 diabetes is urging others to take part in NHS research.

Banbury’s Jack Newman volunteered for the study after he was diagnosed with type 1 diabetes in March 2017, aged 16.

He spoke as researchers invite people with diabetes, their family, friends and local school children to mark World Diabetes Day on 14 November at an event on diabetes research in Oxford.

The Banbury and Bicester College student, now 17, said: “All I remember was being at home and then waking up in a hospital bed. It was a very scary experience, but it’s all a bit blurry and I don’t remember too much of it.

“I was ill for about two weeks before and getting worse and worse. I was being sick all the time, I couldn’t eat or drink anything and I lost around two stone in weight.

“It got to the point where I couldn’t get out of bed and it was progressively getting scarier and scarier and worse and worse, to the point that I had to call an ambulance.”

Jack spent two days in an inpatients unit at Oxford’s John Radcliffe (JR) Hospital.

He said: “I didn’t really feel much at first, but after a couple of days I realised that this was a permanent thing and it did put me in a depressive state for a couple of months because I got told I had this illness I’d have to deal with for the rest of my life.”

Jack’s mother, Claire Newman, was contacted by researchers from the JR about the study in April 2017.

Jack said: “My mother told me about it and I met up with the study nurse for the first time who gave me a book with a full briefing.”

Some people with diabetes have to inject insulin after meals with a syringe called an insulin pen.

Jack said: “I wanted to take part right away. The main thing that persuaded me was that I wouldn’t have to use an insulin pen anymore.”

People with type 1 diabetes lose the ability to produce insulin, which controls the amount of glucose, or sugar, in the blood, causing their levels to become too high. This can cause serious long-term health problems such as blindness, cardiovascular disease and stroke.

In the “Closed Loop from Onset in Type 1 Diabetes” (CLOuD) study, an insulin pump is connected via bluetooth to a continuous glucose monitor (CGM)and a mobile phone app.

A pump is a portable device given to people with diabetes to deliver insulin through a tube placed under the skin. A CGM is a sensor attached to the skin which measures glucose levels and transmits these to the app to calculate how much insulin the pump needs to deliver.

This is known as an artificial pancreas because the app adjusts the amount of insulin delivered by the pump according to the glucose levels present, as the pancreas does in those without diabetes.

Researchers want to find out if an artificial pancreas is more effective at preserving the body’s insulin producing cells in the pancreas than multiple daily injections with an insulin pen in those newly diagnosed.

Insulin pumps are available through the NHS for those with type 1 diabetes, however these alone cannot accurately release insulin according to the body’s needs.

Children and young people recently diagnosed with type 1 diabetes aged 10 to 16 are invited to take part in the study, which is open until 2019.

After a parent or guardian has given consent, participants are randomly allocated to receive insulin injections or an artificial pancreas for two years, to compare the two.

Jack, who was allocated the artificial pancreas, said: “The first couple of times injecting I was off about it, because it was stabbing myself with a needle and I wasn’t used to it. It’s like pricking your finger, it will hurt for a second and then it will be fine.

“The pump’s easier to use, it’s more convenient. If I need insulin, I don’t need to find my pen. It’s made the adjustment from not having diabetes to having it so much easier. It’s made my whole treatment for diabetes so much less stressful.

“It has helped my blood sugar a lot since I’ve been on the trial. The data from before I was on it until afterwards, shows before I was on it my blood sugars were higher.

“It’s made it a lot easier to eat when I’m going out. I don’t need to go into my bag and find my insulin and calculate how much I need. It’s just a lot quicker.”

The study is led by Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge with funding and support from the National Institute for Health Research (NIHR), the Leona M & Harry B Helmsley Charitable Trust and type 1 diabetes charity JDRF.

Dr Rachel Besser, Paediatric Diabetologist, who leads the study at Oxford University Hospitals NHS Foundation Trust, said: “We hope that this technology will control blood sugars better and preserve the function of the pancreas in children with type 1 diabetes. If the function of the pancreas can be preserved it makes living with diabetes that much easier; there will be less swings in blood sugar levels; less lows, and less highs after eating. In the longer-term that should reduce the risk of diabetes-related complications, such as eye disease, kidney disease and early death from heart disease.”

World Diabetes Day is an annual global awareness campaign led by the International Diabetes Federation.

Researchers, people with diabetes, their family, friends and local school children will stand in a circle to recreate a blue ring symbol of World Diabetes Day for a photograph at 11am around the Triton Fountain at the Radcliffe Infirmary Quarter, Woodstock Road, Oxford, followed by an information event in the adjacent St Luke’s Chapel.

The event is organised by the NIHR Oxford Biomedical Research Centre and researchers from the Oxford Centre for Diabetes, Endocrinology and Metabolism (part of the Radcliffe Department of Medicine at Oxford University).

Summary:

An Oxfordshire teenager who is using a mobile phone app connected to a pump to deliver insulin as part of a study into type 1 diabetes is urging others to take part in NHS research.